| NPI | 1790004869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNA MARIE CAREY Office Manager 253-838-9996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00003460) |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2010-05-27 |